The Kenyan Alliance Insurance is a leading Insurance and Financial Services Company offering a wide range of financial products and services in insurance. The product range includes life and general insurance, pensions, investment planning, wealth management, retirement planning and medical insurance.

As part of our growth strategy, the Company seeks to recruit a dynamic, passionate, innovative and result orientated professional to the below position;

Main Purpose of the Job- (Job Summary)

The role holder is responsible for preauthorising clients’ services, ensuring seamless interaction between clients and providers, vetting of claims received and generating patient claim analysis reports and making recommendations on areas of improvement.

Department

Healthcare

Main Responsibilities
•    Inform patients regarding general preventative care practices as well as individualized care plans.
•    Keep track of patients’ records, especially electronic records, and keep current with computer technology, software, security measures, and legislation regarding patient privacy and other issues.
•    Streamlining business operations and instituting measures to improve care using technological advancements.
•    Create schedules, evaluate personnel, and give performance reviews.
•    Handle the 24 hour emergency line and customer service delivery.
•    Pre- authorizing dental, optical, admissions and services above stipulated limits as per set guidelines
•    Generate in patient claim analysis reports and make recommendations on areas of improvement
•    Participate in pitching for business
•    Reviewing medical reports and claims for compliance within guidelines
•    Vetting of claims as per clinical and departmental set guidelines
•    Provide technical expertise on case management
•    Organize health talks and customer education in liaison with marketing and underwriting department
•    Investigate and report adverse occurrences relating to client’s management, policy with appropriate action to ensure compliance with quality patient care;
•    In liaison with the physician, maintain appropriate cost, case, and desired patient outcomes;
•    Evaluate patient satisfaction and quality of care provided;
•    Other duties as may be assigned.

Knowledge & Experience
The candidate must demonstrate and possess the following skills and qualifications:
•    Graduate with a degree preferably in Nursing, Clinical Medicine or a relevant field
•    At least 5 years relevant experience
•    Good understanding of Case Management.
•    Mature, team player with supervisory skills.
•    Proficient in the use of Microsoft office suite and packages.

If you are interested in the position and have the required qualifications, please email a detailed CV indicating the current and expected salary and cover letter clearly indicating ‘CARE OFFICER ’ on the subject line to hr@kenyanalliance.com by 29th October 2021. Only shortlisted candidates will be contacted.